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12 Cards in this Set
- Front
- Back
Medulloblastoma with Extensive Nodularity Better Prognosis than Conventional MB More Differentiated |
Initial +DWI Think Infarction- First postop month Enhancement at margins suggest tumor- Common cause of pseudo progression! |
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Later On: +DWI Think Hypercelluarity and presence of tumor |
Avastin Causes Decrease Perfusion Pseudo regression |
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Spectroscopy: Confusing Postop Tumor &/or Inflammation |
Contrast Enhancement Is Least Helpful Postop |
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Methylated MGMT are sensitive to Temozolomode
IGF-1 Secondary GBM Better Outocme |
Temozolomide Prevents Repair of DNA- causes cancer cells to die |
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Avastin Targets/Blocks VEGF Decrease Enhancement Pseudo Regression |
Two Postop Tumor Both Enhance Perfusion Curve differeniates Steep Curve=tumor Gentle Curve=Related Necrosis |
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Perhaps Permeability is better than Perfusion for Brain Tumor Recurrence- Permeability on Purple Margins last image- Permeability New software |
Stippled Enhancement Looks like Pepper Cut Open- Likened to Seeds of a Pepper Effect of RadioRx |
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1% Develop Cysts After XRT |
Development Satellite Lesions Ependymal Enhancement Suggest Tumor Recurrence |
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Mixture of Enhancement, Perfusion, etc. Confusing!!! |
Most Times Unfortunately There is a Combination of Treatment Induced Necrosis & Islands of Viable Tumor |
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Looks Bad Initially Perhaps part infarct enhancing |
Pseudo Progression: Subacute Infarction Enhancement |
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Pseudo Progresssion with Temozolomide 2-6 Months Looks Worse Actually Have Better Prognosis |
Increased Perfusion Suggest Viable Tumor Insular Cortex |
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Steroids=Pseudo Regr. Avastin =Pseudo Regr. Decrease Enhancement & Perf. BUT Persistent Flair and Restricted Diff ADC |
Enhancement Decrease then Recurs FLAIR progressive worsening |
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Sxs & Gd Not help Flair and ADC most helpful to Differeniate Pseudoprogression and Pseudoregression |
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